Sanctuary

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

2696 Issued in GU

Legal business name

SANCTUARY

Practice address

406 Maimai St
Chalan Pago, GU 96910-5669

Phone

(671) 475-7101

NPI assigned

Oct 24, 2012

Last updated

Oct 24, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mildred Q. Lujan

Title

Executive Director

Phone

(671) 475-7101

Specialties & licenses 6

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christa Porte, LCSW

  • Clinical Social Worker
  • Chalan Pago, GU
  • NPI 1336062587
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1891048062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 MAIMAI ST",
            "city": "CHALAN PAGO",
            "state": "GU",
            "postal_code": "969105669",
            "telephone_number": "671-475-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 MAIMAI ST",
            "city": "CHALAN PAGO",
            "state": "GU",
            "postal_code": "969105669",
            "telephone_number": "671-475-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "LUJAN",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "Q.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "671-475-7101",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GU",
            "license": "2696",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GU",
            "license": "2696",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "GU",
            "license": "2696",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "GU",
            "license": "2696",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GU",
            "license": "2696",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GU",
            "license": "2696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Expresscare Health and Skin Center
• Payless Markets Inc (Superdrug Pharmacy-Agana Payless)
• Christa Porte, LCSW
• Ian Richardson, M.D.,
• Lee Saltzgaber, MD
• Smart Energy Design, Inc. (Smart Energy Design, Inc. dba Guam Medical Transport)

• Emotionally Disturbed Childrens' Residential Treatment Facility in Chalan Pago, GU
• Providers in Chalan Pago, GU by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.